THE FEAR FACTOR OF ADMINISTERING CANCER MEDICATION TO YOUR CAT
Apparently, I will be posting on occasion now. What’s new for someone who sees quitting anything as the biggest failure known to humankind?
Since my short departure from blogging, my cat, Moush Moush, has had surgery at the specialty center here to remove as much of the myxosarcoma that has recurred after nearly 4 years of being cancer-free. I mentioned this in my last post. Her oncologist said “recurrence” at our post-op visit and I was too worried to ask if he’s not suspecting vaccine-associated sarcoma now or not, as I’m not sure which is really worse. Regardless, she had an excellent surgeon again and he was even able to get clean margins from the area excised per the histopathology report, although he couldn’t get the necessary 3 cm margins in all directions and with soft-tissue sarcomas, getting clean or even wide margins is rarely curative. This is what I haven’t figured out and am so frustrated by.
Due to the fact that Moush Moush already had an amputation 4 years ago, which should have been curative at this point, as well as her age (around 12 or 13), her oncologist and and I vetoed surgery that would have removed part of her body wall, including her ribs, to obtain wider margins underneath the cancer—again not usually curative—and we are passing on radiation, as it would involve a full month of M-F treatments, is again not normally curative, and is hard on pets. I won’t even mention the cost of radiation, as I’ve already blown a good chunk of my savings thus far, not that I care when it comes to Moush Moush.
So, we settled on surgery to get as much of the cancer and clean margins as possible and then planned to start a new, cancer drug called Palladia that falls into the class of targeted therapy. It is off-labeled in cats so no studies are available at this time. In layperson’s terms, it works to kill the cancer cells by cutting off the blood supply and at the gene level it cuts the rungs of the DNA, per my blogging friend who is a biologist. Chemistry is all Greek to me! Unfortunately, it only works if the cancer has a certain gene, or was it genes, involved. However, if it works, it controls the cancer and what more could you ask for as Palladia has a rather safe profile, although Moush Moush will need blood work every 2 weeks for a month to make sure her kidneys and liver are okay.
Due to Moush Moush’s small size, the Palladia had to be compounded and I was told I could get a liquid with a flavor. Goodie. Oh, I should mention I am giving this to her every other day all by myself, which seemed so great with my driving issues. It arrived this Friday on ice packs at my request and the fear factor started when I saw the bag it came in—see photo above. I did know I needed to wear disposable gloves when dealing with Palladia, even if in a pill form, and her oncologist’s assistant really stressed all of this to me due to my own health issues, which I disclosed this time around. I decided midnight would be our set time and sat and stared at that bag with my crappy vision the rest of the day.
I started to get this sick feeling in my stomach that wouldn’t go away. Everything I’ve read says this is not traditional chemotherapy, but her oncologist calls it chemo. Even then, pets do very well with chemo and the low doses they are given. It wasn’t helping as I counted down the time until I had to give Moush Moush this drug that has to work, but can also cause things like kidney failure. What had I gotten myself into?
Midnight was drawing near, so I had a talk with my late grandfather, who I often talk to when things get bad. I’m aware this is probably not normal and don’t really care. My grandfather was tough as nails and also a stomach cancer survivor, which led to peritonitis after his GI tract ruptured post-op and a 3-month stay in the ICU on the brink of death 2 years before I was born. Who else to talk to? I like to think he looks over Moush Moush, not that I ever saw him around a cat in my life. Being the strange person I am, I lit the Shabbat candles for the first time in years, but I only have one scented candle in glass so I hoped that would suffice. After all my bizarre rituals were done, I got my gloves on and got down to business.
I carefully got the lid off the bottle of the compounded Palladia after shaking it. Oh, did it stink. Was it the artificial chicken flavor or the drug? I saw there was a plastic plug in the opening, which I presume was to prevent it from exploding in flight. Well, it took 10 minutes to get that off with my stiff fingers and I was so afraid it would pop off and the liquid would fly all over me, but I went very slowly at the end and no spillage. I noticed the liquid was mustard colored, almost like a bouillon cube. Again, was this the flavoring or the drug? It’s not like Moush Moush equates mustard coloring to chicken, which she’s allergic to, hence my need to make sure this flavoring was artificial.
From there, I struggled to draw the thick liquid into the teeny syringe with the goal of not knocking over the bottle, which I’m known to do. She takes 1 mL of the liquid and that was the entire syringe so I was freaking out that she’d never swallow all of this nasty stuff. Per the assistant’s instructions, I grabbed some paper towels to hold under her in case she spit it out and headed over to her temporary bed under the table like the most evil person on earth.
I swear my hands were trembling at that point. The clock had struck midnight and how would Moush Moush react? Would the Palladia work? I won’t ever know unless it doesn’t, which is doing wonders for my nerves. Would she get the GI side-effects I have to watch out for and then I’d have a toxic mess to clean up and if she did, could it just land on all the towels on the floor? Oy vey.
I knelt down with the syringe and paper towels and held her head up and got the syringe into the side of her alligator mouth and tried to push on the plunger and nothing. The liquid was so thick I had to push really hard to finally get it to come out and then came the awful sounds from Moush Moush—so much for the artificial chicken flavor. It felt like it took 5 minutes to get 1 mL into her mouth, but I did it and her tongue and teeth were bright mustard, like I really gave her some radioactive substance that was glowing.
A drop got on the towel I have on her pillow and the liquid was on my gloves, but what to do with the glowing syringe? I had to rinse it. Now the sink was going to be toxic and my gloves were a mess so I tried my best to lift the faucet’s handle with my forearm. I rinsed off my gloves and wrapped the not-so-clean syringe in Kleenex and threw it in the scary, chemo bag where I’m keeping the bottle of Palladia. I had a plastic, grocery bag ready ahead of time and took my gloves off inside-out and threw those in there with the paper towels and tied it in a knot. It still felt toxic so I double bagged it, washed my hands for 5 minutes, and then took the bag to the garbage down the hall. I came back and washed my hands again, but still hadn’t gotten rid of the fear factor.
Moush Moush was fine all last night and today, not that she’s taken this drug long enough to notice anything I suppose. I now have a massive case of OCD, but if Palladia works, I’ll just add that to the long list of issues to work on with my counselor.
Moush Moush hasn’t played with her rats much in 4 years, but it’s rather odd that she chewed all the fur out on the side of the one on the left ions ago, so at least she has a friend with a similar look.